Provider Demographics
NPI:1831707959
Name:MAI-SOTO, JIN YAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JIN
Middle Name:YAN
Last Name:MAI-SOTO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 SUMMER ST STE 300
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5513
Mailing Address - Country:US
Mailing Address - Phone:203-588-9059
Mailing Address - Fax:203-678-8688
Practice Address - Street 1:999 SUMMER ST STE 300
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5513
Practice Address - Country:US
Practice Address - Phone:203-588-9059
Practice Address - Fax:203-678-8688
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist